Individual provider Active NPI

Christeine Michelle Terry, PH.D.

  • Clinical Psychologist
  • Seattle, WA
National Provider Identifier
1467754101
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY60341032 Issued in WA
Practice address
509 Olive Way Ste 1360
Seattle, WA 98101-2555
Phone
(206) 623-5825
Fax
(206) 623-5895
NPI assigned
Dec 1, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY60341032 WA
Clinical Psychologist 103TC0700X PY60341032 WA Primary

Addresses

Primary practice location

509 Olive Way Ste 1360
Seattle, WA 98101-2555

Mailing address

509 Olive Way
Ste 1360
Seattle, WA 98101-2555
Phone (206) 963-6313

Other identifiers 1

IdentifierTypeStateIssuer
1467754101MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2021 through Jan 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY60341032WAMDPsychologist
2182ORMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Christeine Terry, PH.D., LLC CurrentSince Sep 27, 2020 Accepting new patients
Samantha Burns Artherholt, PHD, LLC Clinical CurrentSince Sep 27, 2020 Accepting new patients

Locations

509 Olive Way
Ste 1360
Seattle, WA 98101
Phone (206) 623-5825

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1467754101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY",
            "address_2": "STE 1360",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012555",
            "telephone_number": "206-963-6313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 OLIVE WAY STE 1360",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981012555",
            "telephone_number": "206-623-5825",
            "fax_number": "206-623-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERRY",
        "first_name": "CHRISTEINE",
        "middle_name": "MICHELLE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-01",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60341032",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60341032",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467754101",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.